[Socio-demographic and clinical-psychological characteristics of patients with residual schizophrenia and directions of their psychosocial rehabilitation]. / Sotsial'no-demograficheskie i kliniko-psikhologicheskie osobennosti patsientov s ostatochnoi shizofreniei i napravleniya ikh psikhosotsial'noi reabilitatsii.

OBJECTIVE: To analyze the socio-demographic, clinical and psychological characteristics of patients with residual schizophrenia, to identify variants of residual states and to determine measures for psychosocial rehabilitation on this basis. MATERIAL AND METHODS: At the time of investigation, 91 patients with the diagnosis of residual schizophrenia (F20.5xx according to ICD-10) were under dispensary supervision in the psychoneurological dispensary No. 18 of Moscow. A study of the medical records of all these patients was carried out. Twenty-three patients consented to face-to-face examination. The Positive and negative syndrome scale (PANSS), the Symptom Checklist-90-Revised (SCL-90-R), the Brief Assessment of Cognitive Functions in Schizophrenia (BACS) and the author's questionnaire concerning the opinion of psychiatrists on the clinical and social characteristics of patients with residual schizophrenia were used. Mathematical and statistical methods implemented in the STATISTICA 12.1 software and the Excel office suite were used. The method of stochastic nesting of neighbors («T-distributed Stochastic Neighbor Embedding¼, t-SNE) implemented in the Python program to cluster cases and identify variants of residual states was used. RESULTS: The patients with residual schizophrenia belonged to the cohort of elderly patients (mean age 66.3±13.28 years) with a predominance of females (62.22%). At the time of examination, the course of the schizophrenic process had a negative impact on the social life and professional activities of patients, which led to disability of 74.72% patients and 91.55% of them had disability due to a mental disorder. The analysis showed that patients with residual schizophrenia was a heterogeneous group with a predominant presence of negative symptoms in the clinical picture (the composite score on the PANSS negative subscale was17.79±6.67). Three variants of residual states were identified using clustering by the t-SNE method of individual PANSS indicators. Deficiency symptoms with features of pseudoorganic syndrome prevailed in the first variant. In the second variant, patients had mild positive symptoms, mainly in the form of paranoia and residual delirium, as well as a psychopathic syndrome. The third, small group, included patients with the most favorable variant of remission, having a fairly high level of social adaptation, mainly with personality changes. CONCLUSION: The obtained data were correlated with the results of a psychological examination. It was revealed that patients with residual schizophrenia were not sufficiently included in the process of psychosocial treatment and rehabilitation. Taking into account the identified variants of residual states, the directions of possible psychosocial interventions were determined.

[Innovative technology for assessing the level of compliance of mentally ill people]. / Innovatsionnaya tekhnologiya otsenki priverzhennosti lecheniyu psikhicheski bol'nykh.

OBJECTIVE: To develop a technology for evaluating indicators of patient's compliance, taking into account clinical, socio-demographic, psychological characteristics of the patient and characteristics of the family environment, as well as factors of psychiatric care, based on appropriate compliance algorithms and models. MATERIAL AND METHODS: The study included 107 patients (44 men and 63 women) with diagnoses of schizophrenia, schizoaffective and schizotypal disorders that met the criteria of ICD-10, as well as 105 members of their families. A set of 12 clinical and psychological questionnaires and scales was used for data collection. Clinical, statistical (correlation and regression analysis), system analysis methods, and the analytic hierarchy process were used. RESULTS: A technology for converting rank data into numerical information has been developed. The authors provide models for assessing compliance for groups of patients, which were selected based on awareness of the disease, syndromic characteristics, gender. An algorithm for evaluating the weighted, averaged prognosis (in %) of the patient's compliance level in the corresponding groups was developed. Examples of calculations for evaluating the prognosis of patient's compliance are given. CONCLUSION: The developed models for assessing the level of patient's compliance and the identified characteristics of patients, family environment and factors of psychiatric care that are important for compliance make it possible to increase the effectiveness of therapy, justify the choice of personal strategies for psychosocial and psychoeducational interventions, reduce the risk of re-hospitalization, and increase the level of social adaptation and quality of life of patients and their families.

[Processing of rank data obtained within psychometric scales using analytic hierarchy process]. / Obrabotka poluchennykh pri ispol'zovanii psikhometricheskikh shkal rangovykh dannykh na osnove metoda analiza ierarkhii.

AIM: To analyze problems of evaluation of pathological conditions using rank scales, in particular, psychometric scales, and to format the results of processing of the initial rank information on the scale of relations based on analytic hierarchy process. MATERIAL AND METHODS: A set of Russian and foreign publications on the use and processing of data presented in different scales from categorical to scales of relations were analyzed. Statistical, ranking methods, analytic hierarchy process were used. RESULTS AND CONCLUSION: The authors present the simplest examples showing the inadmissibility of rank information interpretation as numerical information. The efficiency of algorithms for conversion of initial rank information into numerical (cardinal) information based on analytic hierarchy process is demonstrated. A cardinal approach to the processing of rank information opens up prospects for obtaining integrated assessments on different scales, which is of interest for clinical practice and research.

[Problems in assessment of the effectiveness of psychosocial rehabilitation and treatment: area of psychosocial interventions, tools and evaluation criteria]. / Problemy otsenki éffektivnosti psikhosotsial'noi reabilitatsii i lecheniia: oblast' vmeshatel'stv, instrumenty i kriterii otsenki.

The literature review addresses the problems arising in assessing the effectiveness of psychosocial rehabilitation, selection of evaluation criteria and methodical tools most often used for this purpose. It is shown that for an objective assessment of the results of rehabilitation it is necessary to take into account the hierarchical structure of both the problems of evaluation and the information to be processed. This information includes both quantitative indicators (age, duration of disease, frequency of hospitalizations, results of biological study) and non-numerical (rank) indicators (severity of psychopathological symptoms, characteristics of compliance, social behavior and patient's environment). The proposed approach to assessing the results of rehabilitation of mental patients involves the development of specific criteria for the effectiveness of rehabilitation based on a multidimensional, hierarchical consideration of mental pathology with the inclusion of clinical and psychopathological, socio-environmental and personal indicators of patients in setting goals and objectives of rehabilitation.

[Scientific bases of the organization of psychiatric care: development of a conceptual framework of modern mental health services]. / Nauchnye osnovy organizatsii psikhiatricheskoi pomoshchi: razrabotka kontseptual'noi bazy sovremennoi psikhiatricheskoi sluzhby.

AIM: Analysis and development of conceptual models of mental health organization allowing to determine the perspective directions of its further development. MATERIAL AND METHODS: The work was based on the collection of scientific publications on the problems of psychiatric care organization as well as the results of own research carried out by the authors over the last 25 years. System analysis was used for the development and analysis of the major conceptual models of mental health care. RESULTS AND CONCLUSION: The system analysis of the major conceptual models of mental health care - from the matrix model to models of the DSM-5 and RDoC, was carried out. Priorities and main AIM: of the research were specified. It has been shown that the Analytic Hierarchy Process should be used, along with traditional methods, to solve the addressed problems.

[Fishes from the Volga-Caspian basin - vectors of pathogens of anthropozoonoses].

In the Volga-Caspian region there is abundant variety of parasitic species from different systematic groups. Some species ofparasites can be pathogenic not only for fish, but also for human that is why studies on the infection rate of commercial fish species by agents of are very topical for today. The work presents materials on invasiveness by the sanitary-significant helminthes of sheat fish, pike-perch, perch, pike, bream, Caspian roach, red-eye, sabrefish, silver bream, anchovy and ordinary kilka, herring, Caspian shad, black-backed shad. In parasite cenoses of all studied representatives of ichthyofauna there were from one to four species of helminthes which are pathogenic for human and warm-blooded animals. The obtained data indicate to the functioning and active circulation of natural foci of invasion ofAnisacidosis, Eustrongylidosis, apophallosis, rossicotremosis, corynosomosis, opisthorchiasis and pseudamphistomosis in the delta and avan-delta of the Volga River, which, in turn, points to the sanitary trouble of the Volga Caspian region.

[Scientific bases of the organization of psychiatric care: the solution of practical problems in the framework of priority research]. / Nauchnye osnovy organizatsii psikhiatricheskoi pomoshchi: reshenie prakticheskikh zadach v ramkakh prioritetnykh issledovanii.

ОBJECTIVE: a system analysis and modeling for important areas of research of the organization of psychiatric services in Russia in the study mental health of the population, identification of factors affecting the formation of the contingent of persons with mental disorders, organizational and functional structure of mental health services and mental health care. MATERIAL AND METHODS: The authors analyzed scientific publications on the problems of psychiatric care organization as well as the results of own research over the last 25 years using system analysis. RESULTS AND CONCLUSION: The approach that allows a creation of a range of population models to monitor the status of mental health based on medical, demographic and social factors (more than 60 factors) of life was suggested. The basic models and approaches for the evaluation of activity of divisions of mental health services at the macro and micro-social levels, taking into account expert information and individual characteristics of patients and relatives, were demonstrated. To improve treatment quality, the models of identification of the factors, which positively or negatively influenced the commitment to psychopharmacotherapy of patients with schizophrenia and their families, were developed.

[Psychiatric hospital: past, present and prospects].

Academic, clinical, social, economic, organizational and other aspects of psychiatric hospitals are discussed in the main sections of the article: development and current state of medical care, prospect of inpatient care. Main measures for the improvement of the activity of psychiatric hospital, their interaction with outpatient organizations are presented. The necessity of improving the image of a psychiatric hospital is emphasized.

[Actual problems of inpatient psychiatric care in Russia].

A comparative evaluation of inpatient psychiatric care in Russia and some other countries is presented. A systematic analysis of the performance of psychiatric hospitals is conducted. The process of the deinstitutionalization in Russian psychiatry is highlighted. A range of problems hindering a reform of inpatient psychiatric service of the country is singled out.

[Mental health of world's population: social and economic aspects (a literature review 2000-2010)].

The authors had analyzed current approaches and results of the evaluation of the economic burden of mental health in the world derived from foreign research in 2000-2010. Sources of information were publications of the WHO database and the WHO regional offices, the database of the National Library of Medicine U.S. "MedLine", archives of publications by leading foreign medical journals in the field of mental health. The burden of mental illnesses, especially depression and anxiety disorders, has been increasing in all regions of the world. It has been shown that obtaining reliable estimates of mental health in modern conditions is only possible on the basis of reliable epidemiological, clinical and social/economic data which requires the development and improvement of mental health services as well as relevant social, public and private entities.

[The system-oriented model of psychosocial rehabilitation].

A model of psychosocial rehabilitation based on the system approach that allows taking into account both the patient-centered approach of the rehabilitation service, the development of its resource basis, the effectiveness of this care system in whole and its patterns as well has been worked out. In the framework of this model, the authors suggest to single out three basic stages of the psychosocial rehabilitation process: evaluation and planning, rehabilitation interventions per se, achievement of the result. In author's opinion, the most successful way for constructing a modern model of psychosocial rehabilitation is a method of hierarchic modeling which can reveal a complex chain of interactions between all participants of the rehabilitation process and factors involved in this process and at the same time specify the multi-level hierarchic character of these interactions and factors. An important advantage of this method is the possibility of obtaining as static as well dynamic evaluations of the rehabilitation service activity that may be used on the following levels: 1) patient; 2) his/her close environment; 3) macrosocial level. The obvious merits of the system-oriented model appear to be the possibility of application of its principles in the organization of specialized care for psychiatric patients on the local, regional and federal levels. The authors emphasize that hierarchic models have universal character and can be implemented in the elaboration of information-analytical systems aimed at solving the problems of monitoring and analysis of social-medical service activity in order to increase its effectiveness.

[Peculiarities of attention in families with schizophrenia: correlation between psychological and neurophysiological characteristics].

A relationship between neurophysiological and psychological characteristics of attention was studied in 18 patients with schizophrenia and their 34 mentally healthy relatives: parents and siblings (20 subjects) and children (14 subjects). In patients, a decrease of P300 auditory evoked potentials significantly correlated with disturbances of attention stability and volume as well as characteristics of involuntary attention. At the same time, in the groups of relatives the anomalies of attention stability and attention in conditions of prolonged concentration were positively related to P300 latency.

[Basic points of conception of quality assurance in mental health care]. / Osnovnye polozheniia kontseptsii obespecheniia kachestva psikhiatricheskoi pomoshchi.

The article presents conceptual approaches to the problem of quality assurance in mental health care, which accumulate a previous national and international experience in the field of medical and psychiatric care quality, taking into account the results obtained by the authors. The article addresses juridical, ethic, economic and organizational aspects of mental health care improvement. Attention is drawn to a need in controlling system and quality evaluation based on adequate and informative criteria and quality standards and in making scientifically founded administrative decisions. Specific criteria for evaluation of mental health care quality, taking into account its main components--structure, process, results--were suggested.

[Quality of life of relatives of mental patients]. / Kachestvo zhizni rodstvennikov psikhicheski bol'nykh.

Usage of quality of life of psychiatric patients' relatives as the parameter of estimation of the quality of psychiatric care is considered. By means of standard questionnaire elaborated by the authors as well as by means of both individual and group conversations the quality of life was analyzed in 40 relatives which lived together with psychiatric patients. Different spheres of their life and difficulties (financial, social-psychologic, production) were examined in families with such patients. The defects of psychiatric care that had direct influence on the quality of life of the psychiatric patients' relatives are outlined.